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Do You Bite Your Nails or Pick at Your Skin? New Research Says This Simple Trick Might Help

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Do You Bite Your Nails or Pick at Your Skin? New Research Says This Simple Trick Might Help
  • Gently touching your arms and fingertips could help you stop biting your nails, picking your skin, or engaging in other body-focused repetitive behaviors, a new study has found.
  • More than half of the study participants who tried the technique, known as habit replacement, said they saw improvement.
  • The technique could be helpful for people who can't see a mental health professional for treatment for BFRBs, experts said.

young woman biting nails on phone

young woman biting nails on phone

Mattia/Stocksy


A simple technique may help people who engage in repetitive behaviors such as fingernail biting, skin picking, and hair pulling, according to a new study.

The research, published last month in JAMA Dermatology, found that making gentle circling motions on certain body parts throughout the day could reduce body-focused repetitive behaviors (BFRBs)—the clinical term for motor habits that become compulsive. An estimated 3% of the global population has a BFRB, according to the TLC Foundation for Body-Focused Repetitive Behaviors.

People might dismiss these behaviors as harmless, but they can lead to serious consequences, Steffen Moritz, PhD, a researcher in the department of psychiatry and psychotherapy at the University Medical Center Hamburg-Eppendorf in Germany and the study’s lead author, told Health.

“There are a number of published cases of life-threatening incidents following sepsis after skin picking and clumps of digested hair in those who eat their pulled-out hair,” Moritz said. “Fortunately, these cases are rare, but BFRBs are not a minor problem across the board and can lead to depression and low quality of life, for example by avoiding intimacy.”

The gold standard for treating BFRBs is cognitive behavioral therapy (CBT), which aims to help a patient identify circumstances and thought patterns that may trigger BFRBs. However, many people don’t seek it out or can’t access it due to a lack of insurance or long appointment wait times. Experts said the strategy examined in the new study—a habit replacement technique—could be especially helpful for people with BFRBs who haven't had the opportunity to receive mental health treatment.

 “I think something like this could be a great way to start to break the cycle,” said Thea Gallagher, PsyD, a clinical psychologist at NYU Langone Health.

9 Things Your Nails Can Tell You About Your Health

What Is a BFRB?

Other examples of BFRBs include cheek or hair chewing and knuckle cracking. These body-focused behaviors are often triggered by circumstances, Susan Albers-Bowling, PsyD, a psychiatrist and psychologist at Cleveland Clinic, told Health. “At the heart of it, it’s a way of coping with negative emotions, stress, or tension,” she said.

Not everyone who occasionally bites their nails or picks their lip needs mental health treatment, Vanessa Litoff, PsyD, an assistant professor in the department of psychiatry and behavioral health at the Icahn School of Medicine at Mount Sinai, told Health. “BFRBs are considered clinically significant—and more than just a nervous habit—when they cause emotional distress, are experienced as beyond that person’s control, and become disruptive to their life,” said Litoff.

They often take a toll on both the mind and body. “Because of the recurrent nature of BFRBs, they often have unwanted physical consequences," she said. "This ranges from physical pain, bruising, and bleeding to scarring, hair loss, and infections.” In extreme cases, BFRBs can lead to fatal medical problems, she added.

"It can be really distressing when you feel like you can’t control something you want to," Gallagher told Health. People often think they will be able to quit the behavior with ease, but it's "so much more difficult than that," she said.

Rapunzel Syndrome—a Hair Eating Type of Compulsive Behavior

How the Circling Technique Fits in With Current Treatment

Aside from CBT, there aren’t many options for treating repetitive behaviors. Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) may help some patients, but researchers haven’t pinpointed a medication that consistently produces effective results in studies. 

Compounding the issue is a lack of access to mental health care or embarrassment around having the disorder. “People with BFRBs are often ashamed of their behavior and do not seek treatment,” Moritz said.

Such barriers make alternative remedies an attractive solution, experts said. Moritz said that fidget toys, often recommended for people with BFRBs as a substitute behavior, inspired his team to examine a different habit replacement technique.

“We wanted to teach a simple behavioral loop that is inconspicuous, easy to implement, self-soothing, and, most importantly, not harmful,” he said.

For the six-week study, the researchers recruited 268 people from social media who said they had a BFRB. They told half of them that they were on the waiting list for a new BFRB treatment, and instructed the rest to do the circling techniques at least twice a day, and anytime they felt the urge to pick, pull, or bite. 

They were given a manual and shown a video demonstrating the various techniques, which included crossing arms and making circles on the forearms or using the index finger to circle the tip of the thumb. Crucially, the instructions directed participants not to apply pressure or touch their nails to their skin.

Almost 53% of participants introduced to the technique reported improvement after six weeks. Only 19% of people in the control group said they saw improvement during this time, leading the researchers to believe the treatment was effective for some participants.

The study was limited in two ways, the authors wrote: There was no verification that participants had received a formal BFRB diagnosis, and the researchers didn’t follow up with participants after the study to determine whether the strategy helped long-term. For this reason, researchers should conduct future studies on habit replacement techniques, said Moritz.

Anxiety Signs and Symptoms

Who May Benefit From Habit Replacement Techniques?

The habit replacement techniques outlined in the study could help anyone who struggles with a BFRB but doesn’t work with a mental health professional, said Gallagher.

She said it’s important to remain patient because it can take time to stop your repetitive behavior. “It’s not going to go away overnight,” she said, adding that it's important to celebrate even incremental improvement. “Even if you only do [a habit replacement technique] 10 percent of the time, that’s still a reduction in the behavior."

That said, Albers-Bowling acknowledged that not everyone who tries the circling technique will see improvement. “The effectiveness can vary depending on the individual and the severity of their BFRB,” said Albers-Bowling.

She advised making an appointment with a cognitive behavioral therapist or adding yourself to a waitlist if the habit replacement technique doesn’t work for you.

“Because BFRBs can be an unseen and sometimes hidden problem, it can cause people to feel painfully alone," said Litoff. "It’s important that people going through this are given the message that this is not uncommon, there is treatment, and change can happen.”

Heat Waves and Poor Air Quality Can Take a Real Toll on Your Heart Health, Study Shows

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Heat Waves and Poor Air Quality Can Take a Real Toll on Your Heart Health, Study Shows
  • Long heat waves combined with extremely poor air quality may as much as double the risk of a fatal heart attack, new research has found.
  • The research found that the effects of extreme weather and air pollution on the cardiovascular system may be especially dangerous for women and the elderly.
  • The study was based on data from one Chinese province; it’s too soon to say whether the findings are applicable to all populations globally, according to experts.

los angeles covered in smog

los angeles covered in smog

Robert Landau/Getty Images


Exposure to extreme heat combined with air pollution may double the risk of having a fatal heart attack, according to a new study.

While this combination raised the risk most significantly, researchers found that the chances of a deadly heart attack also spiked solely during periods of extreme heat or cold.

Doctors said the study, published last month in the journal Circulation, highlights the importance of monitoring time outdoors during extreme weather or when air quality is poor.

“One important takeaway message for patients is that if you have a history of coronary artery disease, especially if you have had a recent or prior heart attack, it is important to take precautions on very hot or very cold days,” Grant Reed, MD, a cardiovascular medicine specialist at Cleveland Clinic, told Health. “It is likewise an important goal for all of us to avoid the effects of smog and poor air quality on our bodies and encourage public health policies that promote better air quality.”

The study comes as extreme temperature events “are becoming more frequent, longer, and more intense, and their adverse health effects have drawn growing concern,” Yuewei Liu, MD, PhD, senior study author and associate professor of epidemiology in the School of Public Health at Sun Yat-sen University in Guangzhou, China, said in a press release.

Extreme heat has already been tied to several health issues, such as heat stroke, heat exhaustion, and respiratory problems. Exposure to extreme cold can cause hypothermia, frostbite, and inflammation of blood vessels in the skin. 

“Another environmental issue worldwide is the presence of fine particulate matter in the air, which may interact synergistically with extreme temperatures to adversely affect cardiovascular health,” Liu said in the press release.

Fine particles come from smoke from fires and emissions from power plants, cars, trucks, and industrial facilities. They’re more dangerous than coarse particles—from dusty roads, dry riverbeds, farms, construction sites, and mines—because they can reach the deepest parts of your lungs or even your bloodstream. 

This type of pollution has already been associated with heart disease. It is also linked to chronic lung disease, preterm births, cancers, and other conditions.

Study: Insomnia Linked to Increased Risk of Heart Attack, Especially for Women

The Link Between Heart Attack, Weather, and Air Quality

For the study, researchers analyzed 202,678 heart attack deaths in China’s Jiangsu province between 2015 to 2020. They examined weather patterns and pollution levels on the days of and the days surrounding the deaths.

They found the risk of a fatal heart attack was twice as high as usual when temperatures ranged from 83 to 98 degrees Fahrenheit for four days and fine particulate pollution measured above 37.5 micrograms per cubic meter. That exceeds the World Health Organization’s air quality guidelines, which recommend that people avoid exposure to more than 15 micrograms per cubic meter more than three to four days a year.

Researchers found an 18% increase in the risk of a deadly heart attack during two-day heat waves. The chances of dying from a heart attack rose by 4% during two-day cold spells when temperatures ranged from 33 to 41 degrees Fahrenheit.

People aged 80 and older had the highest risk of dying from a heart attack during heat waves, cold snaps, or days with poor air quality, the study found. Women fared worse than men during extreme heat.

The researchers don’t know what’s behind the link between fatal heart attacks, extreme heat or cold, and polluted air, but they have some theories.

Dehydration may influence heart attack risk during periods of intense heat, the researchers wrote in the study, while elevated blood pressure and contracting blood vessels could raise the risk of a deadly heart attack on cold days.

The combination of heat and pollution may elevate heart attack risk because people may breathe faster and harder on sweltering days, causing them to inhale even more harmful microscopic particles than usual, the authors said.

How Climate Change Is Worsening Infectious Diseases Across the Globe

Limitations of the Study

The study has limitations, according to the doctors interviewed.

For one, it didn’t prove extreme weather or polluted air causes fatal heart attacks, only that there is an association between these outdoor conditions and heart attack deaths, noted Reed.

The results may also only apply to some regions and populations, Matthew Tomey, MD, a cardiologist and assistant professor of medicine at Icahn School of Medicine at Mount Sinai, told Health. “Studies to replicate this analysis in other areas, including in the United States, would be helpful to appraise the generalizability of the findings,” said Tomey.

Reed echoed that sentiment. “The culture and adaptation behaviors of the Chinese population may be different than other countries, so it would be helpful to repeat the study in the U.S. population as we may see less or even more impressive findings,” he said.

How Safe Is It to Exercise Indoors or Outdoors When Air Quality Is Bad?

How To Protect Your Heart During Periods of Extreme Weather and Poor Air Quality

Reed said that people with heart conditions aren’t the only ones who should monitor their time outdoors during risky conditions. These conditions can harm healthy people, especially if they’re doing strenuous activities outside.

“Extreme heat or cold can put stress on our bodies. It is important to avoid pushing yourself to your full exercise capacity without speaking to your physician first,” said Reed. “Certain activities to avoid may be shoveling snow during the winter or pushing a lawn mower…on very hot days.”

If possible, you should stay inside and use an air conditioning unit during heat waves, he added.

In the press release, Liu suggested other ways to stay safe during periods of extreme weather or poor air quality:

  • Follow the weather forecast
  • Dress appropriately for the temperature
  • Stay hydrated
  • Wear a mask outdoors
  • Avoid busy highways when possible
  • Use an air purifier

Reed noted that it’s important to take precautions when possible, given the known health effects of extreme weather and poor air quality. “This is an important observation, as it suggests fluctuations in climate and air pollution may be contributing to an increase in…deaths,” he said. “This was a well conducted study, with important public health implications.”

Is Your Sleep Schedule Affecting Your Gut Health?

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Is Your Sleep Schedule Affecting Your Gut Health?
  • New research found that an inconsistent sleep schedule could have a negative impact on gut health.
  • Sleep habits and eating habits are seemingly interconnected—maintaining a nutritious, well-timed diet can positively impact the gut microbiome.
  • Experts recommend people aim for consistency in the time they go to bed and wake up, as well as in how late into the evening they eat their last meal.

Maintaining regular sleep patterns may support your gut health, according to a new study.

Researchers from King’s College London found that keeping a consistent sleep schedule by going to bed and waking up around the same time each day may help people avoid “social jet lag.”

Social jet lag, or going to sleep and waking up at very different times during the week, compared to the weekend, can have negative health effects. The research team also found that quality of rest impacted people’s social jet lag.

The new study of roughly 1,000 adults, published earlier this month in the European Journal of Nutrition, analyzed participants’ blood, stool, and gut microbiome, comparing those who maintained a regular sleep schedule to those who did not.

Researchers found that even a 90-minute difference in the timing of the midpoint of sleep impacted gut microbiome composition.

“We were surprised to find a persistent relationship between social jet lag and species living in the gut, independent of age,” Kate Bermingham, PhD, Senior Scientist at ZOE, postdoctoral researcher at Kings College London, and lead researcher on the study told Health.

“We found that a change of 90-minutes either side of the usual sleep midpoint has a significant association with worse markers of diet and microbiome health,” she said.

Man sleeping

Man sleeping

Getty Images / PeopleImages


Sleep Habits and Eating Habits Are Often Connected

The research team concluded that three of the six microorganisms found in the guts of those with social jet lag were associated with poor health conditions, such as obesity, inflammation, stroke risk, and cardiovascular risk.

Social jet lag is thought to affect more than 40% of the UK population, and is most common in teenagers and young adults, tapering with age. The study found that older sleepers were some of the best at keeping their sleep schedule consistent.

Food choices also played a major role in participants' overall gut health.

In addition to having their sleep recorded and stool collected, participants recorded everything they ate in a food questionnaire. Roughly 16% of the participants had social jet lag and were more likely to eat a diet heavy with potato chips, sugary drinks, and fewer fruits or vegetables.

“Poor quality sleep impacts choices—and people crave higher carb or sugary foods,” Bermingham said.

She explained that the research team found that snacking after 9 PM was negatively associated with metabolic health markers; eating late at night could result in less time for the gut to repair as necessary.

“Without sufficient sleep, our gut biome suffers, and insufficient sleep coupled with eating late at night may be more detrimental to health,” she said.

According to the study, heavily-disrupted sleep was one of the main culprits of social jet lag.

These often include individuals who work unorthodox shifts, whose jobs require them to work at night and sleep during the day, sometimes resuming normal sunrise-to-sundown wake schedules on the weekends.

“While night-shift workers may find it difficult to reach for whole foods instead of high-calorie convenience foods, doing so might help,” Ying-Chieh Tsai, PhD, biochemist, gut-microbiome expert, and chief scientist at Bened Life who was not involved in the study said.

“Fiber-rich prebiotic foods may increase gut microbial diversity and help decrease sleep disturbances,” he said.

Regardless of when you’re able to go to sleep, Tsai recommends that individuals still aim for seven to eight hours of sleep, creating the morning as night by investing in blackout curtains or using a sleeping mask, and being mindful of when their last caffeinated beverage was.

He also advises that with new technology it’s easy to set bed and wake times and lock other apps on your phone during that time, to ensure your sleep is uninterrupted.

“It can be tempting to skimp on sleep to emulate a traditional 9 to 5 schedule, especially if you have children or are taking care of elderly family members, however, that may be detrimental to health,” Tsai said.

Previous studies have also suggested that irregular sleep could yield negative health outcomes like mental fatigue and higher levels of inflammation and stroke risk.

One report found that regularly sleeping more than nine hours per night raises the risk of stroke; another recent study found that sleep deprivation leads to changes in gut microbiome composition.

Rising Temperatures Make Sleep a Challenge—Here's How To Stay Cool and Get Some Rest

Maintaining Healthy Habits All Day Long

While the relationship between sleep, diet, and gut health is complex, researchers behind the study at King’s College had actionable recommendations.

They include going to bed and getting up at the same time every day of the week, regardless of work schedule, and eating a healthy diet that promotes gut well-being.

“The key takeaway is to create a consistent sleep schedule and aim to go to sleep and wake up around the same time, as often as possible,” Bermingham said. “Consistency is more important than perfection.”

Tsai firstly recommends avoiding blue light from LED screens before bed, as these reduce melatonin secretion.

He also recommends prioritizing a healthy diet by eating your final meal of the day two to three hours before bedtime to reduce gastroesophageal reflux disease (GERD) and increase the chances of getting quality sleep. Eating a meal or big snack too close to bedtime can disrupt your sleep cycle and increase stomach aches.

“Your diet impacts not only your own body but also the microorganisms that inhabit your gut,” Tsai said.

It’s not just meal times you should consider, but what you’re putting in your body over the course of the day that can also make a huge difference in your gut health.

“When you eat healthy foods that contain prebiotic fiber, this feeds the good bacteria in your gut, allowing them to thrive,” Tsai said. “They, in turn, produce molecules that can be helpful in keeping the digestive tract healthy, and in reducing inflammation in the gut.”

How Summer Affects Your Sleep—And What You Can Do About It

CDC Warns that Some Tick Bites Can Make You Allergic to Red Meat

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CDC Warns that Some Tick Bites Can Make You Allergic to Red Meat
  • According to a new CDC report, alpha-gal syndrome—a red meat allergy that’s kickstarted by a tick bite—is on the rise.
  • A majority of these cases take place in states where the lone star tick resides, primarily the southern, midwestern, and mid-Atlantic regions of the US.
  • Experts recommend taking precautions to avoid tick bites, like wearing pants and long-sleeved shirts, as well as using Environmental Protection Agency (EPA)-registered insect repellant.

A tick bite-related red meat allergy is an emerging public health problem in the United States, according to the Centers for Disease Control and Prevention.

Lyme disease, Rocky Mountain Spotted Fever, and Babesiosis aren’t the only health issues tick bites can cause. Two new reports from the CDC show that alpha-gal syndrome (AGS)—a red meat allergy that starts with a tick bite—may have affected as many as 450,000 people in the U.S.

Symptoms of AGS—including hives, rash, indigestion, nausea, and vomiting—occur a few hours after eating meat or dairy products. Though many cases of AGS are mild, some people may experience anaphylaxis, a life-threatening allergic reaction that affects multiple organ systems.

Between 2010 and 2022, over 110,000 suspected cases of alpha-gal syndrome were reported to the CDC—a figure that is probably lower than the reality, as many people with symptoms likely never get tested.

It's hard to see how prevalent AGS is in the United States without a national surveillance system. But experts predict AGS cases are increasing, likely due to a mix of increased awareness and emergencies.

“This is probably not a new syndrome, but a newly-recognized syndrome. We’re still learning a lot about it,” Daniel Pastula, MD, MHS, the chief of neuroinfectious diseases and global neurology at the University of Colorado School of Medicine and Colorado School of Public Health, told Health. 

A lone star tick on someone's skin

A lone star tick on someone's skin

Getty Images / Joesboy


How Can a Tick Bite Cause a Red Meat Allergy?

According to Pastula, scientists believe that, during a tick bite, tick saliva inoculates humans with alpha-gal sugar, which can trigger an immune response where the body produces antibodies against the sugar.

This can lead to symptoms whenever a person ingests meat, such as pork, beef, mutton, lamb, venison, or another product, like gelatin, that contains alpha-gal.

The sensitivity to meat typically appears four to six weeks after the tick bite.

“In some people, the presence of alpha-gal in the blood triggers a reaction from the body’s immune system, resulting in an allergic reaction to alpha-gal sugar molecules,” Bobbi Pritt, MD, FCAP, a spokesperson for the College of American Pathologists and director of the Clinical Parasitology Laboratory at Mayo Clinic, told Health.

Not everyone who gets bit by a tick and subsequently develops antibodies against alpha-gal will get AGS, said Pastula. Some people can test positive for the antibodies against alpha-gal but never develop AGS.

“Just because someone has a positive test result doesn’t mean they have the syndrome," he said. "It just means they have antibodies against it."

It’s unclear why only some people develop AGS after a tick bite, for example, or how long a tick needs to bite to trigger AGS.

“We don’t know all the details of what’s going on here,” said Pastula. 

15 Facts You Must Know About Ticks and Tick-Borne Illness

AGS Cases Are on the Rise, Yet Insufficiently Diagnosed and Treated

The CDC data found that hundreds of thousands of people in the U.S. are potentially affected by AGS.

CDC researchers evaluated over 350,000 specimens that were submitted by healthcare providers from patients who had suspected cases of AGS. Over 30% of the tests submitted came back positive for antibodies against alpha-gal.

And it appears that cases are rising—the number of people who tested positive jumped from 13,371 in 2017 to 18,885 in 2021.

Ann Carpenter, DVM, MPH, Epidemic Intelligence Service Officer at the CDC and the primary author of one of the recent CDC reports, explained that in addition to more testing, the increase in AGS cases could be connected to the expanding geographic range of the lone star tick.

The lone star tick currently resides in the southern, midwestern, and mid-Atlantic United States. The CDC analysis noted New York, Virginia, and Kentucky have seen the greatest amount of AGS cases, with other states in those regions also reporting high numbers of suspected cases.

The geographic distribution of AGS cases is similar to that of ehrlichiosis, a bacterial infection transmitted by lone star ticks.

According to Carpenter, the CDC hopes the new report makes public health agencies and healthcare providers more aware of AGS hotspots, so they can treat patients accordingly.

While the main surge of AGS cases has been in areas where the lone star tick resides, 23% of the recent AGS-positive patients live in an area where the lone star tick is not usually found. A handful of those patients had reported bites from black-legged ticks.

While in other parts of the world, other tick species are associated with AGS, so far a vast majority of U.S. cases are connected to the lone star tick.

Getting Healthcare Providers Up to Speed on AGS

Despite the fact that AGS detection is increasing, many healthcare providers aren’t familiar with the syndrome.

Another CDC report surveyed 1,500 family and general practitioners, internists, pediatricians, nurse practitioners, and physician assistants across the country and found that over 40% had never heard of AGS. About a third said they weren’t confident in their ability to diagnose or treat patients with AGS.

This is the first national survey assessing healthcare professional (HCP) knowledge and practices, said Carpenter. The findings highlight the need for HCP education to improve patient care in the United States.

“Increasing healthcare provider education and awareness of AGS is needed to hasten and improve the accuracy of AGS diagnoses, patient care, and the understanding of the epidemiology of this emerging condition, and this may result in an increased identification of cases,” said Carpenter.

Preventing Tick Bites Is a Key Way to Prevent AGS

The very best way to prevent AGS is to prevent tick bites. Being prepared is a helpful step toward accomplishing this goal.

Carpenter explained that it’s crucial to use Environmental Protection Agency (EPA)-registered insect repellents when exploring the outdoors. Additionally, wearing pants and long-sleeved shirts can also help prevent bites.

Tick prevention is particularly important when spending time in tick-prone areas, such as tall grasses, shrubs, and leaf litter, said Pritt. 

After your outdoor activities, shower and check your body, clothing, and gear for ticks. If you’re spending several hours outdoors, Pastula recommends intermittently scanning your body for ticks.

If you notice a tick latched to your body, use a pair of tweezers to pull it out as soon as possible. Clean the bite area with soap and water or rubbing alcohol. 

If you experience AGS symptoms—an allergic reaction two to six hours after eating meat—reach out to a healthcare provider such as a primary care doctor or allergist. To make a diagnosis, a healthcare provider will need to run a blood test that looks for antibodies against alpha-gal, conduct a physical examination, and collect details about your medical history.

“People with a diagnosis of tick-borne meat allergy can then be counseled on what foods to avoid in order to prevent potentially life-threatening allergic reactions,” Pitt said. 

While there is no treatment or cure, symptoms can be prevented by avoiding meat, dairy, and other products with alpha-gal.

For some patients, avoiding tick bites for up to five years may lead to a decline in antibodies that cause allergic reactions, said Carpenter. That said, new tick bites could reactivate AGS, and in some people, AGS may last a lifetime.

As Pastula said: “This is just another example that ticks are bad news and to avoid tick bites as much as you can."

How To Get Rid of Ticks in Your Clothes

Could Using AI on Mammograms Help Detect Even More Breast Cancers?

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Could Using AI on Mammograms Help Detect Even More Breast Cancers?
  • New research found that AI-supported mammogram screening was 20% more likely to detect breast cancer than trained doctors.
  • Researchers emphasized that the technology needs to be used in tandem with a radiologist, but it could make the screening process more accurate and efficient.
  • This is particularly important as the United States is facing both a shortage of radiologists and an aging population that requires more imaging as part of their health care.

Artificial intelligence (AI) may be able to better detect breast cancer on mammogram images than trained doctors, a new study found.

The American Cancer Society recommends women who are not at higher risk for breast cancer start annual mammograms by age 45 and should have the choice to start as early as 40. There are many factors, including breast density, that can make it difficult to detect tumors with the human eye.

That said, about 1 in 8 cases of breast cancer are missed on mammograms. The new study found that AI may be able to help resolve that problem.

AI-supported breast cancer screening isn’t perfect yet, but it could help lower overburdened doctors’ workloads in the future and make mammogram readings more accurate. 

“A challenging part of reading screening exams is that the vast majority of exams are normal,” said Kristina Lång, MD, PhD, an associate professor of radiology diagnostics from Lund University in Sweden, who led the study.

“When you have read hundreds of normal exams, radiologists can sometimes overlook a subtle cancer,” she said.

Woman getting a mammogram

Woman getting a mammogram

Getty Images / kali9


Detecting Breast Cancer With More Accuracy

For the randomized, controlled, population-based trial, Lång and her team analyzed mammograms from 80,000 Swedish women who underwent the scans between April 2021 and July 2022.

Half the scans were read by two highly-trained radiologists, and the other half were read by both an experienced radiologist and AI. 

The computer-assisted group detected 20% more cancers in the scans than the human-only team. In raw numbers, this works out to be a detection rate of 6 per 1,000 women screened, compared to 5 per 1,000 with standard reading.

The technology isn’t designed to be used on its own but appears to be quite useful when used in tandem with a trained eye.

Radiologists were able to detect some cases of cancer that the AI missed, and the synergistic pairing of human and computer did not increase the risk of false negatives—when a person has cancer that goes undetected during a mammogram reading.

“There is so much information contained with a mammogram image, much more than the human eye, even a highly trained human eye, can appreciate,” said Debbie Bennett, MD, Chief of Radiology, Division of Breast Imaging at Washington University in St. Louis, who was not involved in the new study.

“The number of pixels in each mammogram far exceeds what our eyes and brains can process,” she said.

AI algorithms are trained using millions of cases of breast cancer, which gives the computers a leg up when it comes to detecting abnormalities in scans, Bennett told Health. 

Once an AI algorithm identifies an abnormality, it takes images of the perceived abnormality that a trained radiologist can evaluate to determine whether or not additional testing—such as an ultrasound or biopsy—is needed.

According to the University of Rochester Medical Center, about 10% of people who get a mammogram require additional testing, but only about 0.5% are found to have cancer.

9 Things To Know Before Your First Mammogram

Computers Are Already Used in Breast Cancer Screening

In the U.S., about 240,000 cases of breast cancer are diagnosed in women every year. Early detection is paramount to outcomes. The earlier cancer is caught, the more effective treatment will likely be.

One aspect that can make it difficult to detect cancerous tumors early using mammogram images is dense breasts—something about half of women over age 40 in the U.S. have.

Dense breasts are composed of a higher amount of fibrous or glandular tissue compared to fatty tissue, which creates more white areas on a mammogram image—the same color as tumors.

That’s why the Food and Drug Administration (FDA) recently amended the Mammography Quality Standards Act (MQSA) of 1992, a law passed to ensure quality mammography, to require mammography clinics to notify people who are found to have dense breasts.

Some clinics already use a computer-based calculation called volumetric assessment of breast density to determine who has dense breasts and to guide clinicians’ assessment of who needs supplemental screening. This method offers a more standardized approach to breast density, which is often left up to the discretion of each individual doctor, said Bennett.

A relatively simplified computer-based image analysis, called CAD, is also already used to pick up patterns in mammograms, which can reveal abnormalities, though it’s much less effective than AI appears to be. 

Bennett noted that there’s still a lot to learn about AI.

“Because the technology is so new, there is a lack of data on the impact of AI in mammography,” she said. “We don't know what the true benefit or harm of the technology is.”

Is AI the Future of Mammography?

The FDA has already approved several AI technologies for breast cancer screening, but they aren’t mainstream yet. Moving forward, it’s likely that breast cancer screenings will utilize both standard methods of evaluating scans and AI. 

“Currently, AI cannot replace humans," Lång said, "but it can make our work more effective and accurate."

Accurate effective work is crucial for the breast cancer screening needs the United States is facing. Last year, the American College of Radiology reported both a shortage of radiologists and an aging population that requires more imaging as part of their health care.

Bennett explained that AI can really lighten the workload for an overburdened radiologist in identifying normal scans. Many scans are definitely cancer-free, and using an AI algorithm that can identify these cases with confidence would free up time for radiologists to review scans that are not definitively normal. 

“That is where the expertise and clinical judgment of a trained radiologist is needed,” said Bennett. 

Doctors will also still play a vital role in communicating information with patients and making judgment calls on what additional screening is appropriate for specific cases.

“Humans have to be in the steering wheel,” Lång emphasized. In Sweden, her clinic is already confident enough to begin implementing AI in breast cancer screenings.

“We know it is safe and since we performed the trial in the same setting," she said, "we feel certain it will work."

Finding a Lump in Your Breast—7 Possible Causes

This Is the Exact Number of Steps You Should Take Every Day to Live Longer

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This Is the Exact Number of Steps You Should Take Every Day to Live Longer
  • The more steps you take each day, the longer you may live, according to new research published Wednesday.
  • As few as 3,967 steps daily may be enough to start reducing the risk of early death from all causes. That number drops to 2,337 daily steps to begin lowering the risk of death from cardiovascular disease.
  • Scientists have yet to identify an upper limit for daily step counts—going over 20,000 steps a day continues to provide health benefits.

person walking across street

person walking across street

Charday Penn/Getty Images


Getting just under 4,000 steps each day may be enough to lower a person’s risk of early death, researchers say—far less than the 10,000 steps many believe to be the optimal amount for health.

The news comes from a new meta-analysis, published Wednesday in the European Journal of Preventive Cardiology. It's the world's largest study to date showing the importance of daily step counts.

The overall consensus: “The more you walk, the better,” lead study author Maciej Banach, Professor of Cardiology at the Medical University of Lodz in Poland, said in a news release.

But researchers found that as few as 3,967 steps daily were enough to start reducing the risk of early death from all causes. That number dropped to just 2,337 daily steps to begin lowering the risk of death from cardiovascular disease.

It doesn't stop there—with every extra 500 to 1,000 steps a day, the research showed that people can continue to reduce their risk of dying from cardiovascular disease or any cause, respectively. And scientists noted that they have yet to identify an upper limit to the benefits of walking; even at 20,000 steps per day, the health benefits only continued to increase.

“There’s no clearly-established exact step goal; the classic 10,000 steps isn’t necessarily data-backed,” said Eric Brandt, MD, a cardiologist and lipidologist at the University of Michigan Frankel Cardiovascular Center, who was not involved in the new research. But “the more activity you can do, the better, and you’re going to keep getting more and more benefit from it.”

Taking 4,000 Steps a Day Can Reduce Dementia Risk—But More Walking Is Even Better

How More Steps Impact Longevity

In order to see how step counts and mortality risk were linked, researchers analyzed data from nearly 227,000 participants across 17 different studies around the world.

All participants in the included studies, at the start, were considered generally healthy or had some possible risk factors of cardiovascular disease, such as high blood pressure, said Banach, who is also an adjunct professor at the Ciccarone Center for Prevention of Cardiology at Johns Hopkins University School of Medicine.

Across all studies, participants had an average age of 64 years old, and 49% of participants were female. The included studies followed-up with participants after an average of seven years to see how step counts related to both cardiovascular mortality risk and all-cause mortality risk.

The researchers identified a "significant inverse association between daily step count and all-cause mortality and [cardiovascular] mortality"—essentially, the more steps taken, the lower the risk of early death from any cause or heart issues.

According to Barach, the minimum number of daily steps needed to start seeing longevity and survival benefits was 3,867; for a lower risk of death from cardiovascular disease in particular, that threshold was 2,337 steps.

Additionally, for every extra 1,000 steps per day, there was a 15% reduction in all-cause mortality; and for every 500 extra steps, there was a 7% reduced risk of cardiovascular death.

Notably, the findings were consistent across different demographic factors, Banach said. Cohorts were based in Japan, the U.S., the U.K., Australia, and other countries, and getting 4,000 steps a day was generally beneficial, regardless of their “climate zone.” The same was true, regardless of gender.

“However, we noticed that the largest reduction of mortality was observed for younger individuals in comparison to older people,” Banach told Health. This could imply that increasing step counts earlier on in life could have an even greater effect. 

The analysis also didn't identify an upper limit for steps—though the data was limited, even among people who walked as many as 20,000 steps a day, the health benefits only continued to increase.

“Until now, it’s not been clear what is the optimal number of steps, both in terms of the cut-off points over which we can start to see health benefits, and the upper limit, if any, and the role this plays in people’s health,” senior study author Ibadete Bytyçi, from the University Clinical Centre of Kosovo, said in a news release. “However, I should emphasize that there were limited data available on step counts up to 20,000 a day, and so these results need to be confirmed in larger groups of people.”

Other limitations of the study include that it was based on observational data, and that the research only identified an association, not causation—meaning it's possible that health and longevity impacted their step count, not the other way around.

But for the most part, "more is always better for the number of steps per day," Banach said.

What Walking Speed Says About Physical and Mental Aging

Incorporating More Movement Into Your Daily Routine

There are no firm public health guidelines regarding step counts at this point, but this study should be encouraging for people looking to improve their general health.

Prior research has suggested that if a person doesn't get 5,000 steps per day, they were considered sedentary, Banach explained. This research essentially undermines that previous definition, study authors said.

Even though it’s true that the more steps a person takes the better, people may feel “discouraged” if they can’t reach higher step goals, he said. Whether due to work or other constraints, the concern is that people won’t bother with getting more steps in since they feel out of reach.

But globally, people take about 5,000 steps a day on average. Banach’s study then would suggest that many people are not sedentary, but are in fact already reaping some benefits of a lower mortality risk.

Steps can be hard to define—a leisurely stroll or a run would hypothetically both count, Brandt said—but walking to increase step count can be a useful tool to improve health. Unlike other forms of exercise, walking requires no training or special equipment.

Brandt said he tells his patients to track their movement by how many minutes of exercise they’re getting—current guidelines recommend at least 150 minutes of moderate-to-vigorous physical activity per week.

Banach prefers measuring step count. 

“I always recommend to my patients, to not only measure the time of their activity per week, but also to try to measure their steps per day, or number of steps per week, per month,” he said. “It is a number we can always very strictly associate with the concrete risk reduction of cardiovascular outcomes.”

If someone does choose to go this route, a pedometer, smartphone, or other device, can be a useful way to track steps.

Whether it’s measured in minutes or steps, simple things such as walking a dog, walking to appointments instead of driving, or parking further away from the door can all add more movement into a person’s day to day, Brandt and Banach said. 

And it can also be easier to work in terms of averages, Banach added. 

“[It] doesn’t mean that you need to have, for example, 7,000 or 6,000 steps every day. It means that you should have 6,000 steps per day on average,” he said. “If you do not have time to increase the number of steps during the week, try to be proactive during the weekend.”

The overall findings suggest that, as helpful and essential as medications and treatments are to improve health, lifestyle changes—like diet and exercise—matter just as much, if not more.

"In a world where we have more and more advanced drugs to target specific conditions such as cardiovascular disease," Banach said in the news release, "I believe we should always emphasize that lifestyle changes, including diet and exercise […] might be at least as, or even more effective in reducing cardiovascular risk and prolonging lives."

Upping the Intensity of Simple, Everyday Activities Could Lower Your Risk of Cancer

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Upping the Intensity of Simple, Everyday Activities Could Lower Your Risk of Cancer
  • New research has found that increasing the intensity of everyday activities—like taking the stairs instead of the elevator—may reduce your risk of cancer.
  • The time spent moving isn't the driving factor, it's how high your heart rate gets throughout the movement you're doing.
  • Experts recommend finding creative ways to move while you do things you already enjoy, like doing arm circles during TV commercial breaks.

Doing everyday activities at slightly higher intensity levels may lower your risk of cancer, a new study finds.

According to the new research, published earlier this month in JAMA Oncology, upping the intensity of everyday activities could potentially lower someone's cancer risk by as much as 32%.

Known as VILPA, or non-exercise vigorous intermittent lifestyle physical activity, this kind of movement includes activities that often naturally occur, like carrying heavy grocery bags, playing tag with your kids, or taking the stairs.

Researchers found that doing these activities at a slightly higher intensity in short bursts—about one minute at a time—throughout the day significantly reduced cancer risk. 

“Any activity a person does during their everyday life has the potential to become VILPA, if they do the activity at a higher intensity than normal for short bursts of time,” said Matthew Ahmadi, one of the study’s researchers and a postdoctoral research fellow at the University of Sydney
Faculty of Medicine and Health, School of Health Sciences.

“This makes it much more feasible for people to engage in VILPA because they do not need to do it for prolonged, continuous bouts," Ahmadi said. "The accumulation of short VILPA bursts throughout the day will add up.”

Man walking up the stairs

Man walking up the stairs

Getty Images / Cavan Images


Small Movements Are Better Than No Movement

To understand how VILPA impacted cancer risk, the research team out of Australia analyzed health data from more than 22,000 adults in the U.K. The average participant age was 62 years old and all participants indicated that they did not exercise.

While taking part in the study, the participants wore activity trackers on their wrists. The researchers then looked at cancer-related diagnoses, hospitalizations, and deaths over a period of several years.

They discovered that those who participated in VILPA for an average of four and a half minutes per day had a 32% reduced risk of cancer in cancers that are impacted by physical activity like breast cancer, colon cancer, and endometrial cancer.

"Even though study participants were not doing any structured exercise, about 94% recorded some [VILPA] and 92% was done in very short bursts lasting up to one minute," Ahmadi said.

He explained that the minimum dose of VILPA was about three and a half minutes per day. This was associated with a 17-18% reduction in cancer risk when compared to people who participated in no activity throughout their day.

According to Ahmadi, some plausible biological pathways could explain these results. Previous, early-stage trials had shown that VILPA can lead to rapid improvements in cardiorespiratory fitness.

“Cardiorespiratory fitness, in turn, is linked to less insulin resistance and chronic inflammation—both of which are major risk factors for cancer,” he said. In fact, studies have shown poor fitness is directly associated with higher insulin resistance in both women and men.

The research team initiated this VILPA-focused research because there is very little scientific information on incidental physical activity and major health, including cancer. Additionally, vigorous and intense activity has many practical advantages and it is time efficient, Ahmadi said.

"The large majority of middle-aged and older adults—more than 70% to 80% in most countries—are not regular exercisers in leisure time, or simply never do any exercise," he said. "For this reason, we need to better understand how people can benefit from incidental or lifestyle physical activity that occurs during daily routines."

The Benefits of 10 Minutes of Moderate to Vigorous Activity Daily

Previous Studies Support the Idea That Short Movements Are Beneficial

A study that appeared in the European Heart Journal last year found similar results—that short bursts of activity could impact longevity and reduce disease risks.

In this study, researchers looked at almost 72,000 adults around the age of 62 who were free of cardiovascular disease or cancer. What they discovered is that two-minute bursts of vigorous activity totaling 15 minutes a week are associated with a reduced risk of death.

Another study found that as few as 11 minutes of daily exercise can substantially reduce a person’s risk of early death. It can also help prevent heart disease, stroke, and some cancers, in comparison to being sedentary.

“I have long said, based on my opinion from what I could ascertain from literature, pulsed moments of cardiovascular exercise…during the day, could debatably be better than two to three days of 45 minutes of intense exercise,” Sanjay Juneja, MD, a triple board-certified hematologist and medical oncologist at Mary Bird Cancer Center told Health.

It is not so much the fat burning with exercise that matters, but instead, the act of getting your body working that improves your immune system.

"Blood circulates better to areas that may be more or less idle," he said. "Lymph fluid that has toxins gets mobilized [and] your glucose-insulin-glucagon axis gets a workout, which helps with glucose regulation and storage."

A Few Quick Bursts of Physical Activity Each Day May Lead to a Longer Life, Study Shows

The Importance of Exercise for Cancer Prevention

While this most recent study was purely observational and was not designed to directly explore cause and effect, it is still in line with findings from other research that supports the notion that exercise is an important component of cancer prevention.

“One of the most important things someone can do to help them feel more empowered, improve their quality of life, and reduce their cancer risk is exercise,” said Monique Gary, DO, MSc, FACS, a board-certified, fellowship-trained breast surgical oncologist and medical director at Grand View Health/Penn Cancer Network Cancer Program.

"For those who are at elevated risk, studies show that exercise can decrease that risk for the development of cancer during their lifetime," she said.

Exercise also contributes to overall wellness through the reduction of certain hormones that promote cancer growth, as well as the release of endorphins and anti-inflammatory substrates.

“[Meanwhile], a lack of exercise can be a key contributor to cancer risk, through the development of obesity, elevated stress levels, endogenous hormone production, and other factors, which exercise can help mitigate,” Gary said.

According to Roberto Benzo, PhD, a cancer control researcher with The Ohio State University Comprehensive Cancer Center, exercise also has a number of biological effects on the body that have been associated with cancer development and progression.

Of note, is the fact that exercise can lower the levels of sex hormones and growth factors and prevents high levels of insulin—both of which have been linked to breast and colon cancer.

Exercise also reduces inflammation, improves the immune system, and alters the metabolism of bile acids, Benzo said. It also helps prevent obesity, which is a risk factor for 13 types of cancers.

Adding VILPA to Your Daily Routine

The key to VILPA is the intensity. You want to get your heart rate up and sustain the activity for around one minute or more.

Juneja explained that the heart rate associated with "super intense activity" is generally your age minus 220.

"So, if you're 40, healthy, intense exercise would be a heart rate of 180. This number, however, is for the very determined," he said. "Even hitting that 120 to 150 mark is certainly beneficial."

You also can try taking the stairs or parking farther away than usual and jogging to the store, Benzo said. "Wear athletic clothing if possible—this will make it easier to engage in higher-intensity activities. [Also], look for opportunities at home, work, or during play."

Liudmila Schafer, MD, FACP, a medical oncologist, suggested activities like carrying heavy grocery bags, participating in gardening tasks like digging, raking, or mowing the lawn, and performing strenuous household chores like scrubbing floors or washing windows to mee your quota of VILPA.

You also can opt for low-impact VILPA activities and perform multiple repetitions, Gary said. Arm circles, raised leg circles, or walking in place can all be done easily and as part of your otherwise normal routine—you can even do these activities as you watch television.

"When you link exercise to more pleasurable activities that are typically sedentary like watching television, it helps to shift your mindset from considering exercise as work to thinking of movement as a component of leisure, which helps with adoption and consistency," she said.

Gary also encourages the use of fitness trackers and wearables so that you can not only stay on track but also have metrics that can guide your goals and track your progress.

"By being mindful of cancer risk factors, and how exercise plays a role in risk mitigation, it can also help us to manage other chronic illnesses, such as diabetes and hypertension," she said. "The rising tide truly lifts all boats!"

How Moving More and Sitting Less May Help Lower Breast Cancer Risk

Brain Bleeds Are the Newest Risk Linked to Low-Dose Aspirin Use for Older Adults

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Brain Bleeds Are the Newest Risk Linked to Low-Dose Aspirin Use for Older Adults
  • Older adults who take low-dose aspirin on a daily basis may be prone to an increased risk of brain bleeds, according to a new study.
  • While aspirin appeared to reduce the occurrence of ischemic stroke, it was not statistically significant.
  • Experts recommend people seek advice from their healthcare provider before beginning to take low-dose aspirin for stroke or heart attack prevention.

Taking daily, low-dose aspirin may increase older adults' risk of brain bleeds while doing very little to lower the risk of ischemic stroke, a new study finds.

While it was at one point fairly common for older adults to be advised to take low-dose aspirin for the sake of stroke prevention, research—and the paralleling medical advice—is shifting.

The new research is the latest evidence to show that routine use of low-dose aspirin is not suited for older adults with no history of heart conditions or history of strokes. Findings did suggest that older people who are prone to falls, which can cause brain bleeds, should be cautious of taking aspirin.

“Amongst older people, low-dose aspirin appears to lead to an increased risk of intracranial hemorrhage of various types,” Professor John McNeil, an author of the paper and Professor of Epidemiology & Preventive Medicine at the School of Public Health & Preventive Medicine at Monash University told Health.

"It emphasizes the need to avoid aspirin as a primary preventive intervention in older people,” McNeil said.

Older man talking to doctor

Older man talking to doctor

Getty Images / Jose Luis Pelaez Inc


US Task Force Proposes New Low-Dose Aspirin Guidelines to Prevent Heart Attack or Stroke—Here's What to Know

Finding a Link Between Aspirin and Brain Bleeds

The study used data from Aspirin in Reducing Events in the Elderly (ASPREE), the largest randomized controlled trial of low-dose aspirin, to organize their participant pool.

The 19,114 participants were from Australia and the United States, reported their race or ethnicity as Black or Hispanic, and were over the age of 70. They did not have any symptomatic cardiovascular disease, and anyone with a history of stroke or heart attack was not included in the study.

The research team randomly assigned 9,525 people to take 100 milligram daily doses of aspirin and 9,589 people to take placebo pills. The study then followed participants for a median of 4.7 years in hopes of better understanding the link between daily, low-dose aspirin use and brain bleeds.

“In the elderly, the risk of bleeding is substantially more common than in younger people and the trade-off between a possible reduction of ischemic strokes and an increase in intracerebral bleeding has not been reported," McNeil said.

The study found a significant increase–38%—in intracranial bleeding resulting from a combination of hemorrhagic stroke and other causes of intracerebral hemorrhage among individuals who took aspirin.

Researchers found that 312 participants had their first ischemic stroke during the study. Of these, 24 people died due to the stroke. In addition, 187 people had bleeding inside the skull, which included people who had a hemorrhagic stroke.

Aspirin also appeared to reduce the occurrence of ischemic stroke, though not statistically significant, according to researchers.

Aspirin Is Not The Answer

McNeil noted that these findings provided another reason to avoid the use of aspirin in older people who do not need to be taking it.

“They support the conclusions of the guidelines released last year by the US Preventive Health Task Force (USPSTF) advising against initiating aspirin for primary prevention in people over 70 years,” he said.

The new data also supports the recent recommendation of the USPSTF, that low-dose aspirin should not be prescribed for preventing a first heart attack or stroke in healthy older adults.

In addition to its anti-inflammatory effects, which have been well known since ancient times, aspirin prevents blood clot formation by inhibiting the aggregation of platelets in the bloodstream, Jordan Amadio, MD, an attending neurosurgeon at the Department of Neurosurgery, Dell Medical School at the University of Texas at Austin, told Health.

While this may help reduce the risk of clots, the side effect of this is an increased risk of bleeding that does not stop easily.

“Bleeding into the brain, which is like a bomb exploding into a neighborhood of dense high-priced real estate, can be catastrophic,” Amadio said. “Older adults are at higher risk for brain bleeding for a variety of reasons, including poorly regulated blood pressure, fragile blood vessels prone to rupture, or head trauma due to falls.”

Low-dose aspirin, or baby aspirin, is commonly recommended to adults for preventing heart attacks and strokes.

“In popular culture, we sometimes think of ‘taking an aspirin’ as something benign and mild, but it is a powerful blood thinner with a variety of physiological effects,” Amadio told Health. “If aspirin were invented today, it is doubtful that you could buy it over the counter."

He emphasized that aspirin should be used like any other medication—with a consideration of risks and benefits.

While some people who've had a heart attack take a daily baby aspirin as an effective heart attack prevention strategy, others with no history of cardiovascular disease or heart attack take it as well.

A 2019 study estimated that roughly 29 million Americans who have no history of heart attack or cardiovascular disease take aspirin daily, thinking it will prevent a first heart attack.

Nearly 7 million do it without the recommendation of a healthcare provider.

“For some people, the risk of daily aspirin use outweighs the potential benefits,” Karla Robinson, MD, Fellow at the American Academy of Family Physicians and Medical Editor at GoodRx told Health.

She encourages people to make this decision with a healthcare provider, taking into consideration your personal needs and history.

For patients with risk factors that may increase the risk of head trauma, like frequent falls, having a discussion with your healthcare provider about treatment options is the best option for you.

For patients that need to be on daily aspirin or still benefit from daily low-dose aspirin use, Robinson recommends checking with your healthcare provider to confirm the proper dosage and usage you’re taking, given your medical history.  

"This new study really highlights the importance of weighing the risk of having a brain bleed from aspirin treatment against your risk of ischemic stroke," she said.

Taking Low-Dose Aspirin Every Day May Increase Risk of Anemia in Older Adults

Recall: Zespri Kiwis Pulled From Shelves Over Possible Listeria Contamination

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Recall: Zespri Kiwis Pulled From Shelves Over Possible Listeria Contamination
  • Certain Zespri brand kiwifruit have been voluntarily recalled due to possible listeria contamination.
  • The recall affects one-pound clear plastic clamshells of organic green kiwifruit bearing the Zespri brand name.
  • No illnesses have been reported to date, but consumers are urged not to eat the affected kiwifruit and to discard them immediately.

Zespri Kiwi Recall

Zespri Kiwi Recall

Courtesy of Oppy


Certain Zespri brand kiwifruit are being voluntarily recalled due to possible listeria contamination, according to an announcement shared Tuesday by David Oppenheimer and Company I, LLC (Oppy).

The recall affects one-pound clear plastic clamshells of organic green kiwifruit bearing the Zespri brand name and UPC code 8 18849 02009 3. The affected clamshells contain fruit stickered with the GTIN bar code 9400 9552.

According to the company's announcement, the recalled green kiwis were grown in New Zealand and then exported to North America where they were repacked.

The affected kiwifruit was shipped between June 14, 2023 and July 7, 2023 and sold at retail locations in 14 states throughout the U.S.: Florida, Georgia, Illinois, Indiana, Kentucky, Missouri, North Carolina, New York, Ohio, Pennsylvania, Tennessee, Texas, Virginia, and Wisconsin.

Zespri organic green kiwifruit sold in any of the other 36 states is not affected by the recall. Any kiwifruit shipped after August 7, 2023 is also not affected.

The recall was reportedly the result of a routine sampling conducted by the Kentucky Department of Health on July 7, 2023. Oppy was then notified of the results and worked with Zespri to trace the affected products back to grower lots.

Distribution of organic green kiwifruit from the affected lots was immediately stopped, as the company continues its investigation into the affected fruits.

The recall announcement noted that no illnesses linked to the potential kiwifruit contamination have been reported so far, and no other Oppy products are part of the recall.

Trader Joe's Recall: Certain Falafel and Soup Products May Contain Rocks, Insects

Identifying Listeriosis

The affected kiwifruit was recalled due to the potential to be contaminated with Listeria monocytogenes, a bacterium that, when ingested, can cause an infection called listeriosis.

The Centers for Disease Control and Prevention estimates that 1,600 people get listeriosis each year, and 260 die from the infection. Listeriosis can be serious and sometimes fatal in young children, frail or elderly people, and people with weakened immune systems.

The infection is often less severe for immunocompetent people, but in pregnant women, listeriosis can cause miscarriages or stillbirths.

For those who are at risk for serious or fatal outcomes from listeriosis, the infection may turn into an invasive illness or an infection spread beyond the gut.

Symptoms of invasive listeriosis start within two weeks of eating contaminated food and may include:

  • Fever
  • Flu-like symptoms
  • Headache
  • Stiff neck
  • Confusion
  • Loss of balance
  • Seizures

In less severe cases, listeriosis stays confined to the gastrointestinal system. Symptoms of intestinal illness linked to Listeria infection typically start within 24 hours of eating contaminated food and include diarrhea and vomiting.

Invasive listeriosis is typically treated with antibiotics; intestinal illness from listeriosis usually clears up on its own and can be managed with supportive care, like pushing fluids.

These Are the Top 10 Foods Most Likely to Be Linked to Recalls and Disease Outbreaks

Preventing Listeriosis

There may not be a foolproof way to prevent listeriosis, but it's possible to choose foods that are less likely to be contaminated with Listeria.

Elderly people, people with weakened immune systems, and pregnant people and newborns may want to avoid the following foods to protect their health:

  • Unpasteurized soft cheeses (including queso fresco and brie)
  • Unheated deli cheeses and meats, hot dogs, and fermented or dry sausages
  • Premade deli salads (coleslaw, potato salad, chicken salad, etc.)
  • Refrigerated meat spreads or smoked fish
  • Raw or lightly-cooked sprouts
  • Pre-cut melon
  • Raw (unpasteurized) milk, yogurt, and ice cream

To make many of these risky foods a bit safer, they can be cooked until "steaming hot" or at least 165 degrees Fahrenheit. Homemade foods and fruits that you cut up yourself are also often safer options.

As for the recalled kiwifruit, Oppy urged people who may have the fruit in their home not to eat them and throw them away immediately. People may also contact Oppy with questions at 1-866-698-2580, Monday–Friday from 9 a.m. to 4:30 p.m. PDT, or email contact@oppy.com.

Is There A Right Time To Eat Breakfast to Reduce Your Risk of Type 2 Diabetes?

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Is There A Right Time To Eat Breakfast to Reduce Your Risk of Type 2 Diabetes?
  • New research found that eating breakfast earlier in the day may lower a person's risk of type 2 diabetes.
  • It was also found that individuals who ate their last meal earlier in the day—before 9 PM—saw a lower incidence of type 2 diabetes.
  • Experts recommend people not only focus on when they're eating, but what they're eating, to help lower their type 2 diabetes risk.

Eating an earlier breakfast may help lower your risk of type 2 diabetes, a new study finds.

Many people may be tempted to skip breakfast in the mornings, but new research shows that making time for breakfast—and eating it earlier in the day—might include essential health benefits.

The study, published last month in the International Journal of Epidemiology, found that those who routinely ate an earlier breakfast—specifically before 8 AM—were less likely to develop type 2 diabetes than those who ate breakfast after 9 AM.

Similarly, study participants who tended to eat later dinners—especially past 9 PM or 10 PM—had a higher incidence of type 2 diabetes than those who ate dinner earlier in the day.

The relationship between type 2 diabetes risk and meal timing was consistent even when other factors were discounted, explained Anna Palomar-Cros, PhD, MPH, study author and postdoctoral researcher at ISGlobal Barcelona Institute for Global Health.  

“These results were independent of multiple variables including the education, the diet quality, or the levels of physical activity of the participants,” she told Health. “Beyond the nutritional quality of the diet, having an early first meal may be associated with a lower incidence of [type 2 diabetes].”

If the link is confirmed by more research, Palomar-Cros said, it could “lead to promising lifestyle interventions.”

This could be a helpful strategy, especially since 1.3 billion people are expected to have diabetes by 2050.

Here’s what experts had to say about the link between meal timing and type 2 diabetes risk, and how the body's internal clock can play a role in our health.

Woman eating breakfast by the window

Woman eating breakfast by the window

Getty Images / FreshSplash


Eating Early—Not Fasting Late Into the Day—Helped Lower Risk

Diet quality and quantity are frequently studied when it comes to diabetes, so researchers wanted to look a bit closer at meal timing.

Palomar-Cros and her team looked at data from 103,312 adults involved in a large French study cohort. Almost 80% were women, and the average age at baseline was about 43 years old.

The meal timings and frequency were recorded in 24-hour dietary records for the first two years of the study. After an average 7-year follow-up, the researchers analyzed meal timing, number of meals, and fasting time overnight to see if any had a relationship with type 2 diabetes.

Over the course of the study, 963 people developed type 2 diabetes; their dietary records looked different than those who didn’t develop the disease. People who habitually ate breakfast after 9AM had a notably higher incidence of type 2 diabetes.

Additionally, people who ate dinner earlier had a slightly lower risk of developing type 2 diabetes. There was also a slightly lower disease risk in people who had a higher number of eating occasions, eating six or seven times a day versus just two or three.

A longer overnight fasting time—the time between someone’s last meal of one day and first meal of the next—only had an effect on diabetes risk when it was also associated with an early meal time, Palomar-Cros explained. 

“A night-time fasting of more than 13 hours would be associated with a lower [type 2 diabetes] incidence only when fasting is broken at 8AM or before,” she said. 

This would suggest that popular intermittent fasting strategies where people don’t eat until late morning or midday could actually be harmful to those looking to avoid type 2 diabetes, said Palomar-Cros.

6 Simple Diet Changes That Help Prevent Type 2 Diabetes

Why Does Meal Time Have an Effect?

The connection between breakfast time and type 2 diabetes risk bolsters the idea that eating and the body’s natural rhythms have a unique relationship. It’s usually only discussed in the context of sleep, but the body’s circadian rhythm and people’s food intake can have a significant impact on health.

“Circadian rhythms are involved in virtually all functions of the body and are regulated by the circadian clock, which is mainly synchronized by light but also by food,” Palomar-Cros said. “The correct functioning of this system is crucial to ensure an optimal metabolism.”

Previous research has found that the body’s circadian rhythm can control glucose, insulin, glucose tolerance, and appetite. These systems tend to peak in the morning, making it a better time for people to eat.

According to Mia Zhu, MPH, RD, certified diabetes care and education specialist at Duke Health, your hormones tell your liver to release sugar into the bloodstream when you wake up.

Eating shortly after waking up triggers hormones such as insulin, said Zhu, which then helps move sugar into cells and out of the bloodstream.

High blood sugar is the hallmark of type 2 diabetes, which is why people with the condition are encouraged to eat a daily breakfast.

Meal timing aside, simply prioritizing eating breakfast might be a good way for people to lower their risk of developing type 2 diabetes. One study found that when people eat a daily breakfast, they’re less likely to develop metabolic syndrome symptoms such as high blood pressure and high blood sugar. 

“Your mom told you to eat your breakfast when you were a kid—it still holds true today,” said Zhu. “It is the most important meal of the day.”

More research is still needed to see if meal times and circadian rhythms might change based on seasonal differences or different regions across the globe, or if there’s some sort of other underlying factor connecting type 2 diabetes and meal timing, Palomar-Cros said. 

It’s also possible that the study results may have looked a bit different if there was an equal gender breakdown between men and women in the study cohort, since men have slightly different hormones and circadian rhythms.

Timing of Meals for Diabetes

Doing What You Can to Prevent Type 2 Diabetes

Eating an earlier breakfast may be one possible way to reduce the risk of type 2 diabetes, but it’s certainly not the only one. 

For one, getting regular exercise is a great way to reduce a person’s risk of developing type 2 diabetes, Palomar-Cros and Zhu agreed. 

Current guidelines suggest that people should be getting 150 minutes of moderate-intensity physical activity each week, in addition to two instances of activity that strengthens muscle. Intensity levels will vary for each person, but the goal is that people get their heart rate up—try walking briskly, riding a bike, playing tennis, swimming, or jogging.

It’s also important that people pay attention to what nutrients they’re putting in their body. Palomar-Cros recommends reaching for non-starchy vegetables such as peppers, broccoli, or mushrooms, as well as fruit, lean sources of protein, and whole grains like quinoa. It’s best to avoid sweetened beverages, highly-processed foods, and trans fats if possible, she added. 

These lifestyle changes may take time. But committing to eating an earlier breakfast—or just eating breakfast in general—is a good place to start.

“If you’re struggling with eating breakfast, something is better than nothing,” Zhu said. “Don’t think of it as a first meal of the day, but maybe a snack. Grab a piece of fruit and some nuts, or a string cheese, or even just a yogurt as you go out the door.”

19 Healthy Foods To Eat for Breakfast

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